What is Hallux Rigidus?
Hallux Rigidus is a form of degenerative arthritis at the metatarsophalangeal (MTP) joint, where the base of your big toe attaches to the foot. Arthritis refers to inflammation of joints due to degeneration of the smooth cartilage that lines the ends of bones in a joint. This cartilage breakdown leads to painful bone-on-bone contact, swelling, stiffness, and restricted movement. Hallux Rigidus is also called "stiff big toe."
Symptoms
Hallux Rigidus, or stiff big toe, causes pain and stiffness in the toe, which may gradually become swollen and inflamed. You may experience difficulty wearing shoes or high heels. A bone spur may also develop on top of the joint.
Causes
Hallux Rigidus can be caused by:
- Aging
- Autoimmune conditions
- Congenital foot abnormalities
- Injuries
- Overuse
- Being female
- Certain medical conditions such as rheumatoid arthritis or gout
Untreated Hallux Rigidus
If left untreated, the pain can worsen over time and lead to restricted movement. The foot becomes stiff, potentially causing a limp and difficulty finding comfortable footwear.
Diagnosis
Your doctor will assess your symptoms and take a medical history. The foot will be examined for evidence of bone spurs, and diagnostic tests such as X-rays, MRI, or CT scans may be ordered.
Treatment
Initial non-surgical treatments may include:
- Medications: NSAIDs or other pain relievers
- Ice packs: To reduce swelling
- Shoe modifications: Stiff soles or rocker-bottom shoes
- Orthotic devices: Footpads, braces, splints, or casts for stabilization
- Injection therapy: Steroid injections into the MTP joint
- Physical therapy: Exercises to improve flexibility, motion, and strength
Surgical Options
If non-surgical treatments fail, your doctor may recommend one of the following:
- Cheilectomy: Removal of bone spurs to restore toe motion
- Osteotomy: Realignment or removal of damaged bone
- Arthrodesis: Joint fusion, often used for older patients
- Interpositional Arthroplasty: Placement of donor tissue between joint ends to relieve pain
